The Licensure Debate: Should Naturopathic Doctors be Regulated?

by Lorraine Caron

Naturopathic medicine is a distinct system of health care with a rich history. Its roots extend back to European nature cure, homeopathy, western herbalism, and American eclectic medicine. Naturopathic medicine is not defined by the techniques that may be used, but instead a unique view of health and disease guides the practice, which is based on six principles.

The most fundamental principle is the healing power of nature. It is understood that every living thing has a vital force which is always attempting to heal.

In every patient encounter, the intensity of treatment is matched to the severity of the sickness and the strength of the patient. This is what it means to do no harm.

Naturopathic doctors are committed to treating the cause. Therapies which suppress or cover up symptoms are sometimes necessary or helpful, but true healing only happens when the reason for symptoms is addressed.

Research over the last twenty years in psychoneuroimmunology (mind-body medicine) has increasingly shown that mind, body and spirit are not separate. Naturopathic doctors treat the whole person.

Naturopathic doctors are teachers who work to help patients understand why they’re sick, how they will get well, and how they can maintain good health.

This patient education is one part of prevention, the last of the six principles. Holistic medicine means not only treatment when sick, but everything that will lead to better health in the future.

In Colorado, there are about 100 naturopathic doctors who are graduates of federally-accredited, four-year, residential naturopathic medical schools. These schools are colleges and universities which provide an education comparable to other doctoral-level professional programs. Naturopathic doctors are highly-trained health care providers who also have extensive training in clinical nutrition, herbal medicine, physical medicine, homeopathy, and lifestyle counseling.

In some regulated states, naturopathic doctors practice as primary care providers whose services are covered by private and public insurance. In Colorado, the practice of naturopathic medicine is unregulated. The Colorado Association of Naturopathic Doctors (CoAND), an affiliate of the American Association of Naturopathic Physicians, actively supports legislation to license naturopathic doctors in Colorado.

There are very good reasons for regulating doctors. There is a higher standard for those who are considered experts in their field.

Regulation, first and foremost, protects public safety. The Colorado Department of Regulatory Agencies in 2008 reported that improperly trained providers (some of whom had as little as six months of online coursework) had indeed caused harm in Colorado and elsewhere. They recommended licensure of naturopathic doctors. Licensure holds doctors accountable at the state level for appropriate education and practice. Coloradans deserve better than “buyer beware” when it comes to their health care.

Colorado, like much of the country, suffers from a shortage of primary care providers. Naturopathic doctors are well-positioned to help fill this need, because most practice primary care. What is clear from other recently-licensed states is that once regulation is in place, more doctors come, which benefits patients.

Colorado citizens should have the right to choose the type of provider they see. Consumers who want qualified naturopathic care should be able to access it. When insurance covers care, access increases substantially, and that only happens with regulation.

Historically, there have been two concerns raised about licensing naturopathic doctors in Colorado.

Some licensed and certified practitioners have expressed concern that defining a scope of practice for naturopathic doctors would mean an infringement on their own scope, but this isn’t the case. Every regulated profession has a list of therapies which they may use, and there is definite overlap. Medical doctors, osteopathic doctors, nurses, acupuncturists, chiropractors, and dietitians are all allowed to make dietary recommendations, for example.

The other worry has been that unregulated alternative practitioners would be put out of business if naturopathic doctors are licensed. In Oregon, a state which has licensed naturopathic doctors since 1927, a quick Google search returns thousands of listings for health coaches, homeopaths, reiki practitioners, and other unregulated practitioners. The success of stores such as Whole Foods and Trader Joes in licensed states is also indisputable.

Naturopathic doctors are well-trained holistic health care practitioners. Licensure will provide standards and accountability, protect public safety, add to the health care pool, and give Coloradans the right to see the doctor of their choice. For more information, please visit www.ColoradoND.org.

Lorraine Caron, ND, graduated from the National College of Naturopathic Medicine in Portland, Oregon. Dr. Caron is a member of the Colorado Association of Naturopathic Doctors, the American Association of Naturopathic Physicians, and the Pediatric Association of Naturopathic Physicians. She lives in Fort Collins with her husband and children.